[Congressional Record Volume 155, Number 186 (Friday, December 11, 2009)]
[Senate]
[Pages S12981-S12984]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  UNANIMOUS CONSENT REQUEST--H.R. 3590

  Mr. DURBIN. Mr. President, yesterday, the majority leader propounded 
a unanimous consent request to have four votes with respect to the 
health care bill. The Republican leader objected to the consent, since 
he indicated they had just received a copy of Senator Lautenberg's 
side-by-side amendment to the Dorgan amendment and so they needed time 
to review the amendment.
  Therefore, I now ask unanimous consent that following the period of 
morning business today, the Senate resume consideration of H.R. 3590 
for the purpose of considering the pending Crapo amendment to commit 
and the Dorgan amendment, No. 2793, as modified; that Senator Baucus be 
recognized to call up a side-by-side amendment to the Crapo motion; 
that once that amendment has been reported by number, Senator 
Lautenberg be recognized to call up his side-by-side amendment to the 
Dorgan amendment, as modified; that prior to each of the votes 
specified in the agreement, there be 5 minutes of debate equally 
divided and controlled in the usual form; that upon the use or yielding 
back of the time, the Senate proceed to a vote in relation to the 
Lautenberg amendment; that upon disposition of the Lautenberg 
amendment, the Senate then proceed to vote in relation to the Dorgan 
amendment; that upon disposition of that amendment, the Senate proceed 
to vote in relation to the Baucus amendment; and that upon disposition 
of that amendment, the Senate proceed to vote in relation to the Crapo 
motion to commit; that no other amendments be in order during the 
pendency of this agreement, and that the above referenced amendments 
and motion to commit be subject to an affirmative 60-vote threshold; 
that if they achieve that threshold, they then be agreed to and the 
motion to reconsider be laid upon the table; if they do not achieve 
that threshold, they then be withdrawn.
  The ACTING PRESIDENT pro tempore. Is there objection?
  Mr. ENZI. Mr. President, reserving the right to object, we are going 
to have three Democratic amendments and one Republican amendment voted 
on, and the Democrats wrote the bill. The Democrats are doing a side by 
side to their own amendment.
  It looks to me like they ought to get together and get some things 
figured out. There ought to be a little bit more fairness on the number 
of amendments. So I object.
  The ACTING PRESIDENT pro tempore. Objection is heard.
  Mr. DURBIN. Mr. President, this is the second time we have offered to 
call amendments for a vote, and the complaint from the other side is, 
you are not calling amendments for a vote.
  How many times do we have to ask for permission to call amendments 
for a vote, run into objections from the Republican side, and then hear 
the speech: Why aren't we voting on amendments?

  I am certain that in the vast expansion of time and space, we can 
work out something fair in terms of the number of amendments on both 
sides. In fact, maybe the next round will have more Republican 
amendments than Democratic amendments. I don't know how many Republican 
amendments or Democratic amendments we have voted on so far. We can get 
an official tally, but that really seems like a very minor element to 
stop the debate on health care--because we need to have an equal number 
of amendments. Can't grown-ups work things out like this and with an 
understanding that we will resolve them? If we can't, then for 
goodness' sake don't subject us to these arguments on the Senate floor 
that we are not calling amendments for a vote. We have just tried 2 
days in a row, and the Republicans once again have stopped us with 
objections. That is a fact.
  I would implore the leadership--not my friend from Wyoming; I know he 
is doing what he is instructed to do by the leaders--for goodness' 
sake, let's break this logjam. Let's not, at the end of the day, say, 
well, we stopped debating this bill when we should have been debating 
it, when we have offered 2 days in a row in good faith to have actual 
amendments offered and debated.
  I would also say, Mr. President, this is the bill we are considering, 
H.R. 3590, when we return to it. This is the health care reform bill, 
and this is a bill which has been the product of a lot of work. A lot 
of work has gone into it both in the House and in the Senate. In the 
Senate, two different committees met literally for months writing this 
bill, and they should take that time because this is the most 
significant and historic and comprehensive bill I have ever considered 
in my time in Congress--more than 25 years. This bill affects every 
person in America--every person in the gallery, everyone watching us on 
C-SPAN, every person in America. It addresses an issue that every 
American is concerned about--the future of health care, how we are 
going to make it affordable.
  At a time when fewer businesses offer the protection of health 
insurance, at a time when individuals find themselves unable to buy 
health insurance that is good and that they can afford; at a time when 
health insurance companies are turning down people right and left for 
virtually any excuse related to preexisting conditions, we cannot 
continue along this road. Those who are fighting change, those who are 
resisting reform, are basically standing by a broken system.
  There are many elements in American health care that are the best in 
the world, but the basic health care system in America is fundamentally 
flawed. This is the only civilized Nation on Earth where you can die 
for lack of health insurance--literally die.
  Mr. President, 45,000 people a year die because they do not have the 
health insurance they need to bring them to the doctor they need at a 
critical moment in life. They do not have the health insurance they 
need to afford the surgical procedure they need to avoid a deadly 
disease.
  If a person has a $5,000 deductible on their health insurance, and a 
doctor tells them--as a man who wrote me from Illinois said--you should 
have a colonoscopy, sir; there is an indication you could have a 
problem that could develop into colon cancer and it could be fatal.
  The man says: How much is the colonoscopy?

[[Page S12982]]

  Well, it is $3,000 out of pocket.
  The man says: I can't afford it. I just can't pay for it.
  So he doesn't get the colonoscopy and bad things can occur. That 
happens in America, but it doesn't happen in any other civilized 
country.
  It is true in some systems he may have had to wait an extra week or a 
month, but he gets the care he needs. He doesn't die for lack of health 
insurance. That is what is going on in America. Almost 50 million 
Americans without health insurance today--almost 50 million in this 
great and prosperous Nation--went to bed last night without the peace 
of mind of the coverage of health insurance. This bill addresses that.
  At the end of the day, 94 percent of the people living in America 
will be able to sleep at night knowing they have a decent health 
insurance plan. That is an amazing step forward. That is a step 
consistent with the establishment of Social Security, which finally 
took the worry away from seniors and their families about what would 
happen to grandma and grandpa when they stopped working.
  I remember those days. There was a time when grandma and grandpa 
retired and moved in with their kids. Remember that era? I do. It 
happened in our family, and they didn't have any choice. They had to 
because they had modest jobs and not a lot of savings and they put it 
on their kids to find that spare bedroom or let them sleep in basement 
that was made over so that they would have a comfortable and safe place 
to be.
  Social Security changed that for most American families. This bill 
will change health care for most American families. The same thing is 
true with Medicare. The critics of Medicare--and they have been legion 
on the floor of the Senate--ignore the obvious: 45 million Americans 
will have peace of mind to know that they can get affordable health 
care once they reach the age of 65. They would not lose their life 
savings. They will get a good doctor, a good hospital, and a good 
outcome.
  Isn't that what America is all about? Isn't that why we are supposed 
to be here? Why don't we have more support? The Republican side of the 
aisle only comes to say what is wrong with the idea of health care.
  Steven Pearlstein, in this morning's Washington Post--which I hope 
some of my Republican colleagues will read--talks about a lost 
opportunity which the Republicans have.
  We have invited the Republicans from day one to be part of the 
conversation about health care reform. Senator Enzi of Wyoming is one 
who assiduously gave every effort, spent 61 days trying to reach a 
bipartisan agreement. It failed, but at least he tried. I commend him 
for trying.
  Too many others on the other side didn't try. But Steven Pearlstein 
writes:

       One can only imagine how Republicans could have reshaped 
     health-reform legislation in the Senate . . . Without 
     question, they could have won more deficit-reducing cost 
     savings in the Medicare program by setting limits on spending 
     growth and reforming the way health care is organized, 
     provided and paid for. And they could have begun to realize 
     their goal of ``consumer-driven health care'' by insisting 
     that the new insurance exchanges offer at least one plan 
     built around individual health savings accounts and 
     catastrophic coverage.

  Pearlstein goes on to talk about the possibilities. He says:

       They could have taken a page from John McCain's platform 
     and insisted on replacing the current tax exclusion of 
     health-care benefits with a flat tax credit that would be 
     more progressive and put downward pressure on insurance 
     premiums.
  I am not guaranteeing that any of those proposals would have been in, 
but they all could have been in if we had a dialog. Instead of a 
dialog, we have a shouting match, one side of the aisle shouting at the 
other side of the aisle. It is exactly the stereotype of Washington 
which America has come to hate. America wants us to solve problems, not 
get into these, you know, fur-flying debates, where we see who can get 
the rhetorical better of the other. They want us to solve problems but, 
unfortunately, we are still waiting for the first Republican to cross 
the aisle on the passage of this bill and work with us. The door is 
still open. The invitation is still there. The idea of doing nothing is 
unacceptable and that should be the message.
  The fact is, there is no comprehensive Republican health care reform 
bill--period. Senators come to the floor, such as Senator Coburn, and 
say: I have some good ideas. I bet he does. I may even subscribe to 
them. But his ideas have not gone through the rigor this bill has gone 
through. This bill was sent to the Congressional Budget Office and 
scored, asking the basic questions: No. 1, will it add to the deficit? 
They came back and told us: No, the Democratic health care reform bill 
will, in fact, save money, $130 billion in 10 years; $650 billion in 
the second 10 years. We asked them: Is it going to insure more 
Americans? They came back and said: Yes, 94 percent will be insured 
when this is over. That same rigor has not been applied to the 
Republican ideas because it is hard, it is tough, and it takes time. I 
commend them for their thoughtful ideas, but to say they have something 
they can match against this bill, comprehensive reform--just go to the 
Republican Senate Web site and look for the Republican comprehensive 
reform bill. Do you know what you will find? You will find the 
Democratic bill. That is all they can talk about. They don't have a 
comprehensive health care reform bill.
  But we are not going to quit. America, we cannot go home for 
Christmas until we get this job done.
  After we have been here 12 straight days debating, we kind of get 
into a trance-like, catatonic state, where we can't remember what our 
last speech was about and we go to sleep at night thinking about what 
we might have said on the floor or what we are going to say tomorrow. 
But the fact is, we have to stay and do our job, not just in passing 
health care reform but doing something significant to help the 
unemployed and deal with jobs and the economy before we leave here to 
try to enjoy Christmas, or what is left of it or the holiday season, 
with our families.
  This is a job that has to be done. I am sorry we have reached a point 
where the Republicans have not been actively involved in creating this 
bill. We tried for the longest time. In the HELP Committee, where 
Senator Enzi serves as the ranking Republican, more than 100 Republican 
amendments were accepted as part of this debate and still not one 
single Republican Senator would vote for the bill in that committee.
  So far the scorecard on Republican participation in health care 
reform debate is a lot of speeches, a lot of press releases, a lot of 
charts on the floor but only two votes--one from a Republican 
Congressman in Louisiana for the House bill; one from Senator Snowe of 
Maine for the Senate Finance version of this bill.
  The ACTING PRESIDENT pro tempore. The time of the majority has 
expired.
  Mr. DURBIN. That is it. I urge my colleagues to join us in a 
cooperative effort to try to come up with something more positive than 
just our lonely speeches on the floor.
  The ACTING PRESIDENT pro tempore. The time of the Senator has 
expired. The Senator from Arizona is recognized.
  Mr. McCAIN. Mr. President, while my friend from Illinois----
  Mr. DURBIN. Mr. President, I ask unanimous consent morning business 
be closed. I wish to make sure Senator McCain has time.
  Mr. McCAIN. I ask for an additional 10 minutes of morning business so 
I could maybe engage in a colloquy with my favorite combatant here.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. McCAIN. Maybe we can talk a little bit about his remarks.
  I have to say, I appreciate the eloquence and the passion the Senator 
from Illinois has brought to this debate. He makes some very convincing 
points. One of the major points--and I would be glad to listen to the 
Senator. I think it is fair for us to respond to each other's comments 
very quickly. The Senator from Illinois said we have been engaged in 
the negotiations and inputs have been made into the formulation of this 
bill.
  I have to tell the Senator from Illinois, I have been engaged in many 
bipartisan compromises, whether it be issues such as campaign finance 
reform, whether it be--a whole large number of issues, including 
defense weapons acquisition reform. I say to the Senator from Illinois, 
do you know what the process was? People sat down

[[Page S12983]]

at the table together when they were writing the legislation. I am a 
member of the HELP Committee, OK? I say to the Senator from Illinois, 
do you know what the process was--because I am on the committee. A bill 
was brought before the committee without a single--Senator Enzi will 
attest to this--without a single period of negotiations, where we sat 
down together with the chairman of the committee, where they said: What 
is your input into this legislation?
  We had many hours of amendments in the committee, all of which, if 
they were of any real substance, were rejected on a party-line vote.
  I have to tell the Senator from Illinois he can say all he wants to 
that there have been efforts to open this to bipartisanship. There have 
not. My experience in this Senate--I know how you frame a bipartisan 
bill and that has not been the process that has been pursued by the 
majority.
  I understand what 60 votes mean. But in all due respect, I say to the 
eloquence of my friend from Illinois, that has not been the process 
which I have successfully pursued for many years, where people have sat 
down together at the beginning, where you are there on the takeoff and 
also then on the landing.
  I would be glad to hear the response of the Senator from Illinois.
  I ask unanimous consent if the Senator and I could engage in a 
colloquy.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. DURBIN. First, those who are watching, this is perilously close 
to a debate on the floor of the Senate, which rarely occurs in the 
world's most deliberative body, where Senators with opposing views 
actually, in a respectful way, have an exchange. I thank the Senator--
--
  Mr. McCAIN. Respectful but vigorous.
  Mr. DURBIN. I thank the Senator from Arizona. Here is what I 
understood happened. I know Senator Dodd came to the HELP Committee 
with a base bill to start with, but it is my understanding, in the 
process, 100 Republican amendments were accepted on that bill. If I am 
mistaken, I know the Senator will correct me, but----
  Mr. McCAIN. I will be glad to correct the Senator from Illinois. 
Senator Enzi is here. None of those amendments were of any significant 
substance that would have a significant impact on the legislation, I 
have to say to the Senator from Illinois. For example, medical 
malpractice, we proposed several amendments that would address what we 
all know, what the Congressional Budget Office says is $54 billion--
other estimates as much as $100 billion--in savings. There were no real 
fundamental amendments.
  I have to say that some of those amendments were accepted. But it 
still doesn't change the fact that at the beginning, as the Senator 
from Illinois said--the bill came to the committee without a bit, not 1 
minute of negotiation before the bill was presented to the committee. 
The ranking member is on the floor. He will attest to that. Please go 
ahead.
  Mr. DURBIN. I would say to the Senator from Arizona, I went through 
bankruptcy reform with Senator Grassley and a similar process was 
followed when the Republicans were in the majority. He produced the 
base-line bill, and I made some modifications and, ultimately, at one 
point in time, we agreed on a bill, came up with a common bill. The 
starting point is just that, a starting point. But I say to the Senator 
from Arizona, look at what happened to the issue of public option. I 
believe in public option passionately. I believe it is essential for 
the future of health care reform, for competition for private health 
insurance companies to give consumers a choice, to make sure we have 
one low-cost alternative at least in every market. Yet, at the end of 
the day, I did not get what I wanted and what is being proposed, now at 
the Congressional Budget Office, is not my version of public option.
  We ended up bending toward some of the more moderate and conservative 
members of the Democratic caucus and toward the Republican point of 
view. I don't know of a single Republican who came out for public 
option. Maybe I am forgetting one. At the end of the day, the point I 
am making to the Senator is there was an effort at flexibility and an 
effort at change to try to find some common ground. Unfortunately, the 
ground we are plowing has only 60 Democratic votes. It could have been 
much different. It could still be much different.
  Mr. McCAIN. May I ask my friend, wasn't the reason the public option 
was abandoned was not because of a Republican objection, it was because 
of the Democratic objection? The Senator from Connecticut stated, 
unequivocally, the public option would make it a no deal.
  I appreciate the fact that Republican objections were observed. But I 
don't believe the driving force behind the abandonment of this public 
option, if it actually was that--we have not seen the bill that is 
going to come before us--was mainly because of the necessity to keep 60 
Democratic votes together.
  Mr. DURBIN. The Senator from Arizona is correct. But I add, Senator 
Snowe has shown, I believe, extraordinary courage in voting for this 
bill in the Senate Finance Committee and made it clear she could not 
support the public option. We are hoping, at the end of the day, she 
will consider voting for health care reform. That was part of the 
calculation.
  Mr. McCAIN. We are hoping not.
  Mr. DURBIN. I understand your point of view, but I would say--you are 
right. But we were moving toward our 60 votes, but it would be a great 
outcome if we end up with a bill that brings some Republicans on board, 
and it was clear we couldn't achieve that if we kept the public option 
in. There are other elements here. We are going to have a real profound 
difference when it comes to the issue of medical malpractice and how to 
approach it. But I think, even on that issue, we could have worked 
toward some common ground, and I hope someday we still can.
  Mr. McCAIN. Could I ask my friend about the situation as it exists 
right now? Right now, no Member on this side has any idea as to the 
specifics of the proposal the majority leader, I understand, has sent 
to OMB for some kind of scoring. Is that the way we want to do 
business, that a proposal that will be presented to the Senate sometime 
next week and voted on immediately--that is what we are told--is that 
the way to do business in a bipartisan fashion? Should we not at least 
be informed as to what the proposal is the Senate majority leader is 
going to propose to the entire Senate within a couple days? Shouldn't 
we even know what it is?
  Mr. DURBIN. I would say to the Senator from Arizona, I am in the dark 
almost as much as he is, and I am in the leadership. The reason is, 
because the Congressional Budget Office, which scores the managers' 
amendment, the so-called compromise, has told us, once you publicly 
start debating it, we will publicly release it. We want to basically 
see whether it works, whether it works to continue to reduce the 
deficit, whether it works to continue to reduce the growth in health 
care costs.
  We had a caucus after this was submitted to the Congressional Budget 
Office, where Senator Reid and other Senators who were involved in it 
basically stood and said: We are sorry, we can't tell you in detail 
what was involved. But you will learn, everyone will learn, it will be 
as public information as this bill currently is on the Internet. But 
the Congressional Budget Office has tied our hands at this point 
putting it forward. Basically, what I know is what you know, having 
read press accounts of what may be included.
  Mr. McCAIN. Could I ask my friend from Illinois--and by the way, I 
would like to do this again. Perhaps when he can get more substance 
into many of the issues.
  Mr. DURBIN. Same time, same place tomorrow?
  Mr. McCAIN. I admit these are unusual times. But isn't that a very 
unusual process, that here we are discussing one-sixth of the gross 
national product; the bill before us has been a product of almost a 
year of sausage-making. Yet here we are at a position on December 12, 
with a proposal that none of us, except, I understand, one person, the 
majority leader, knows what the final parameters are, much less 
informing the American people. I don't get it.
  Mr. DURBIN. I think the Senator is correct, saying most of us know 
the

[[Page S12984]]

fundamentals, but we do not know the important details behind this. 
What I am saying is, this is not the choice of the majority leader. It 
is the choice of the Congressional Budget Office. We may find that 
something that was sent over there doesn't work at all, doesn't fly. 
They may say this is not going to work, start over. So we have to 
reserve the right to do that, and I think that is why we are waiting 
for the Congressional Budget Office scoring, as they call it, to make 
sure it hits the levels we want, in terms of deficit reduction and 
reducing the cost of health care.
  It is frustrating on your side. It is frustrating here. But I am 
hoping, in a matter of hours, maybe days, we will receive the CBO 
report.
  I would like to ask the Senator from Arizona, if he wouldn't mind 
responding to me on this. Does the Senator believe the current health 
care system in America is sustainable as we know it, in terms of 
affordability for individuals and businesses? Is the Senator concerned 
that more and more people do not have the protection of health 
insurance; fewer businesses offer that protection?
  The ACTING PRESIDENT pro tempore. The 10-minute time period has 
expired.
  Mr. McCAIN. I ask unanimous consent for 5 additional minutes.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. DURBIN. Is the Senator concerned as well with the fact that we 
have 50 million Americans without health insurance and the number is 
growing; that in many of the insurance markets across America there is 
no competition, one or two take-it-or-leave-it situations? Does that 
lead him to conclude we cannot stay with the current system but have to 
make some fundamental changes and reforms?
  Mr. McCAIN. I say to my friend, everything he said is absolutely 
correct. I am deeply concerned about the situation of health care in 
America. I know the Senator from Illinois is deeply concerned about the 
fact that it is going to go bankrupt, about the fact that the Medicare 
trustees say that within 6 or 7 years it is broke. From what we hear, 
there is now a proposal over there to extend eligibility for Medicare, 
which obviously puts more people in the system, which obviously, under 
the present setup, would accelerate a point of bankruptcy, at least 
from what I know of this.
  But the fundamental difference we have, in my opinion, is not what we 
want--we both share the deep ambition that every American has 
affordable and available health care--it is that we believe a 
government option, a government takeover, a massive reorganization of 
health care in America will destroy the quality of health care in 
America and not address the fundamental problem. We believe the quality 
is fine.
  We think the problem is bringing costs under control. When you refuse 
to address an obvious aspect of cost savings such as malpractice 
reform, such as going across State lines to obtain health insurance, 
such as allowing small businesses to join together and negotiate with 
health care companies, such as other proposals we have, then that is 
where we have a difference. We share a common ambition, but we differ 
on the way we get there. I do not see in this bill, nor do most 
experts, a significant reduction in health care costs except slashing 
Medicare by some $\1/2\ trillion, which everybody knows doesn't work, 
and destroying the Medicare Advantage Program of which in my home State 
330,000 seniors are a part.
  Mr. DURBIN. I say to the Senator two or three things. First, the CBO 
tells us this bill will make Medicare live 5 years more. This bill will 
breathe into Medicare extended life of 5 additional years. Second, I 
have heard a lot of negative comments about government-sponsored health 
care. I ask the Senator from Arizona, is he in favor of eliminating the 
Medicare Program, the veterans care program, the Medicaid Program, the 
CHIP program to provide health insurance for children, all basically 
government-administered programs? Does he believe there is something 
fundamentally wrong with those programs that they should be jettisoned 
and turned over to the private sector?
  The second question, does the Senator from Arizona want to justify 
why Medicare Advantage, offered by private health insurance companies, 
costs 14 percent more than the government plan being offered, and we 
are literally subsidizing private health insurance companies to the 
tune of billions of dollars each year so they can make more profits at 
the expense of Medicare?
  Mr. McCAIN. First, obviously I want to preserve those programs. But 
every one of those the Senator pointed out is going broke. They are 
wonderful programs. They are great things to have. But they are going 
broke. He knows it and I know it, and the Medicare trustees know it. To 
say that we don't want these programs because we want to fix them is 
obviously a mischaracterization of my position, our position. We want 
to preserve them, but we all know they are going broke. It means cost 
savings. It means malpractice reform. It means all the things I talked 
about. The Senator mentioned Medicare Advantage. That is called 
Medicare Part C. That is part of the Medicare system. There are 
arguments made that there are enormous savings over time because 
seniors who have this program, who have chosen it, who haven't violated 
any law, are more well and more fit and have better health over time, 
thereby, in the long run, causing significant savings in the health 
care system which is what this is supposed to be all about. I ask in 
response: How in the world do you take a Medicare system which, 
according to the trustees, is going broke and then expand it to people 
between age 55 and 64? The math doesn't work. It doesn't work under the 
present system which is going broke. To add on to it, any medical 
expert will tell you, results in adverse selection and therefore 
increases in health care costs.
  Mr. DURBIN. If I may respond, why is Medicare facing insolvency? Why 
is it going broke? Why are the other systems facing it? Because the 
increase in cost in health care each year outstrips inflation. There is 
no way to keep up with it unless we start bending the cost curve. We 
face that reality unless we deal with the fundamentals of how to have 
more efficient, quality health care. Going broke is a phenomena not 
reflective in bad administration of the program but in the reality of 
health care economics.
  What I am about to say about the expanded Medicare is based solely on 
press accounts, not that I know what was submitted to CBO in detail. I 
do not. But the 55 to 64 eligibility for Medicare will be in a separate 
pool sustained by premiums paid by those going in. If they are a high-
risk pool by nature, they will see higher premiums. What happens in 
that pool will not have an impact on Medicare, as I understand it. It 
will be a separate pool of those receiving Medicare benefits that they 
will pay for in actual premiums. It won't be at the expense or to the 
benefit of the Medicare Program itself. What I have said is based on 
press accounts and not my personal knowledge of what was submitted to 
CBO.
  Mr. McCAIN. The Senator has seen the CMS estimates this morning that 
this will mean dramatic increases in health care costs. You may be able 
to expand the access to it, but given the dramatic increase, one, it 
still affects the Medicare system and, two, there will obviously be 
increased costs, if you see the adverse selection such as we are 
talking about.
  I see the staff is getting restless. I ask my friend, maybe we could 
do this again during the weekend and during the week. I appreciate it. 
I think people are helped by this kind of debate. I respect not only 
the passion but the knowledge the Senator from Illinois has about this 
issue.
  Mr. DURBIN. I thank the Senator.

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